MDH -- LTC Issues Committee

1. MDH -- LTC Issues Committee Two ways we’ve looked at future LTC • Understanding the market (demand side) • Understanding the system (supply side)

2. Older Minnesotans Tomorrow How is the “market” changing? Census counts & State Demographer projection

3. Older Minnesotans Tomorrow * tpt research 2006 *

4. Older Minnesotans Tomorrow • Upbeat Enjoyers (19.4%) • Enthusiastic, active, involved • Optimistic about future • Believe age increases attractiveness • Want to expand intellectual horizons • Want to work in “retirement” • Feel financially secure

5. Older Minnesotans Tomorrow • Insecure (36.5%) • Troubled by lack of financial resources • Pessimistic about future • Concerned about crime • Feel age impacts memory and appearance • Few plans for retirement

6. Older Minnesotans Tomorrow • Threatened Actives (25.2%) • Want to preserve independence • Generally positive outlook • Don’t think retirement is time for new interests/growth • Accept themselves as they are • Would like to pass assets to children

7. Older Minnesotans Tomorrow • Financial Positives (18.8%) • Realists and long-term planners • Positive view of their lives • Dissatisfied with current appearance • Have planned not to work in retirement • Feel financially secure • Relentless seekers of value

8. Older Minnesotans Tomorrow Boomers want to “Age in Place” Source: 2005 Survey of Older Minnesotans

9. Older Minnesotans Tomorrow • More will live alone (18% of Boomers are childless, high divorce rates) • Do not think of self as “old” expect to continue “as is” • Car culture: social networks defined by affinity or proximity?

10. Older Minnesotans Tomorrow Can older people stay in their own homes? Source: 2005 Survey of Older Minnesotans

11. CS/SD -- Trends and Experience What is the future LTC Market??? • Control over assistance = Assistive Technologies • Self-help, self-management, self-direction • Minimize change -- stay in home of choice • Minimize disruption in preferred routine • What assistance do people want to buy?

12. CS/SD -- Trends and Experience More efficient use of current workers • Augment with technology • Augment with volunteers • Augment with consumer/caregivers training • Less windshield time; hub-&-spoke models • Less paperwork/administrative hassle (!)

13. TRENDS and CS/SD EXPERIENCE Better links between health and support systems and monitoring • Better chronic disease management • Find “windows of opportunity” for getting consumers’ attention • Focus on high cost combos: dementia, multiple chronic illness • Reduce incidence of crises

14. What DOES LTC System Look Like? Supply side . . . • CMS Grant – State Long-Term Care Profile • Thomson Reuters consultants • Common data and common elements across waivers and populations • HCBS Expert Panel

15. What DOES LTC System Look Like? Ten States • Iowa, Maine, Massachusetts, Virginia, Arkansas, Michigan, Nevada, Kentucky, Florida and Minnesota Common “State Profile Tool” • Developed by Thomson and piloted in Pennsylvania

16. What DOES LTC System Look Like? 7 Target Populations • Older Adults • Adults with Physical Disabilities • Adults with Mental Retardation/Developmental Disabilities • Children and Adults with Mental Illness • Adults Living with HIV/AIDS Infections • Adults with Traumatic Brain Injuries • Children with Special Needs

17. What DOES LTC System Look Like? State Profile Tool elements . . . • Consolidated administration • Single access points • Institution supply controls • Process for transition from institutions • Continuum of residential options • HCBS capacity development • Participant direction options • Quality management system